Live support
Live Chat is only available M - F from 9:00 am to 4:00 pm EST time.

If you need immediate help please fill out the form below or email
us at admissionscoordinator@maryfreebed.com

Text size: A A A

Nutrition and Spinal Cord Injury

A healthy, balanced diet is important for everyone. If you have a spinal cord injury (SCI), a healthy diet is even more important because of changes in metabolism, body composition, and activity levels. You may face physical or environmental challenges with shopping and meal preparation. All of these factors put those with spinal cord injury at higher risk for obesity, diabetes, heart disease, osteoporosis, constipation, urinary tract infections (UTI), and skin breakdown. 


►What is my desirable weight?
How many calories do I need?
How much protein do I need?
What should I do if I am overweight?
What should I do if I am underweight?
Do I need to watch the fat in my diet?
Am I at risk for osteoporosis?
What do I do if I am constipated?

What is the desirable weight for people with spinal cord injury?

Weight charts for people with spinal cord injury aren't available, but as a general guideline you can use weight charts for the general public (see the Metropolitan Life weight charts below). If you have paraplegia, subtract 5-10%; if you have tetraplegia, subtract 10-15%. This accounts for the loss of muscle mass.

Example: If the desirable weight for a 5'11" medium built man is approximately 154-166 lbs., the desirable weight for the same man with paraplegia would be 139-149 lbs. With tetraplegia, the desired weight would be 131-141 lbs. BMI (body mass index) isn't a good estimate of desirable weight or body fat with spinal cord injury because of the decrease in muscle mass.

Height and Weight Table for Women with Spinal Cord Injury

Height

Small Frame

Medium Frame

Large Frame


4' 10"


102-111


109-121


118-131

4' 11"

103-113

111-123

120-134

5' 0"

104-115

113-126

122-137

5' 1"

106-118

115-129

125-140

5' 2"

108-121

118-132

128-143

5' 3"

111-124

121-135

131-147

5' 4"

114-127

124-138

134-151

5' 5"

117-130

127-141

137-155

5' 6"

120-133

130-144

140-159

5' 7"

123-136

133-147

143-163

5' 8"

126-139

136-150

146-167

5' 9"

129-142

139-153

149-170

5' 10"

132-145

142-156

152-173

5' 11"

135-148

145-159

155-176

6' 0"

138-151

148-162

158-179

Weights at ages 25-59 based on lowest mortality. Weight in pounds according to frame (indoor clothing weighing 3 lbs.; shoes with 1" heels)

Height and Weight Table for Men with Spinal Cord Injury

Height

Small Frame

Medium Frame

Large Frame


5' 2"


128-134


131-141


138-150

5' 3"

130-136

133-143

140-153

5' 4"

132-138

135-145

142-156

5' 5"

134-140

137-148

144-160

5' 6"

136-142

139-151

146-164

5' 7"

138-145

142-154

149-168

5' 8"

140-148

145-157

152-172

5' 9"

142-151

148-160

155-176

5' 10"

144-154

151-163

158-180

5' 11"

146-157

154-166

161-184

6' 0"

149-160

157-170

164-188

6' 1"

152-164

160-174

168-192

6' 2"

155-168

164-178

172-197

6' 3"

158-172

167-182

176-202

6' 4"

162-176

171-187

181-207

Weights at ages 25-59 based on lowest mortality. Weight in pounds according to frame (indoor clothing weighing 5 lbs.; shoes with 1" heels).

*Charts adapted from Metropolitan Life
► Top

How many calories do I need after a spinal cord injury?

When major muscle groups are paralyzed, they won't burn calories at the same rate they did before the injury. Excess calories beyond what you require will be stored as fat.

A general formula for calculating calorie needs in soinal cord injury was developed in 1985 and is still being used.

  • If you have paraplegia: 27.9 calories X body weight in kg. (weight in lbs ÷ 2.2 = 1 kg)
  • If you have quadraplegia: 22.7 calories X body weight in kg.

This general formula does not take into consideration gender, age, activity level, or whether you are currently overweight or underweight. A registered dietitian can help you determine an appropriate calorie level for you. However, most people prefer to develop a healthy eating plan rather than count calories.

► Top

How much protein do I need after a spinal cord injury?

People with spinal cord injury have the same protein needs as the general population: 0.8 g per kg of body weight. Typically we eat more protein than we actually need. If you have a spinal cord injury and a wound that is still healing or a pressure ulcer, there's an increased need for protein: 1.2 – 1.5 g per kg of body weight. If extra protein is needed in your diet, your physician or a registered dietitian can help determine what you need.

► Top

What should I do if I am overweight after spinal cord injury?

One of the biggest problems for people with spinal cord injury is obesity. A sedentary lifestyle due to paralysis makes it easy to gain weight and very difficult to lose it. This weight gain will affect mobility by putting extra stress on shoulder joints and making it harder to push your wheelchair. It will also be more difficult to transfer and may affect your independence.

  • You will not be able to eat as much as you did before your spinal cord injury without gaining weight.
  • Stay as active as possible. Engage in different activities or use modifications or adapted equipment. Any exercise is helpful.
  • Eat regular meals. Feeding your body throughout the day will help you control your appetite, and you'll actually eat less than if you skip meals.
  • Watch portion sizes. Read labels to see what a portion size actually is. Restaurant meals are often two times an actual portion. Eat half and take the other half home for another meal.
  • Eat a variety of foods. Try to eat something from each of the food groups (meat/protein, milk, fruits, vegetables, and grains) at each meal.
► Top

What should I do if I am underweight after spinal cord injury?

Being underweight can be just as big of a problem as being overweight. A poor diet can be responsible for weight loss, decreased stamina and strength, thinning of the bones, and skin breakdown from bony protrusions on the hips, buttocks, and sacrum. It can also weaken your immune system, which may increase your chances of getting colds, the flu, and even pneumonia.

Adding the following to your diet my help prevent complications:

  • Nutritional supplements (such as Boost©, Ensure©, or any brand of adult supplement) are an easy way to increase calories and protein.
  • High calorie milkshakes and snacks will also help increase calories.
  • Add calories to the foods you already eat by adding sauces, gravy, butter/margarine, cream cheese, salad dressings, mayonnaise, sour cream, heavy cream, or whipped cream.
  • Add honey, jam, jelly, brown sugar, and peanut butter to your diet.
► Top

Do I need to watch the fat in my diet after spinal cord injury?

Watching the total amount of fat (lipids) in your diet is important for everyone. If you have a spinal cord injury, it's even more important. High fat diets lead to weight gain, and ultimately may lead to heart disease.

With spinal cord injury there's a tendency to gain weight around your middle due to loss of abdominal muscle and decreased activity. If you're gaining weight around your middle, chances are your blood lipid levels are also going up.

A healthy diet limits the amount of saturated fat, trans-fat, and cholesterol, and increases the amount of mono-unsaturated and polyunsaturated fats. The following ideas will help you limit unhealthy fats:

  • Choose non-fat or low fat dairy products.
  • Cook with lean meat or trim the visible fat before cooking.
  • Choose fish more often.
  • Choose low-fat cooking methods: bake, broil, grill, or poach.
  • Avoid or eat a minimum amount of fried foods.
  • Use low-fat salad dressings.
  • Limit the amount of butter, margarine, and oils.
► Top

Am I at risk for osteoporosis after spinal cord injury?

The risk for osteoporosis (loss of bone calcium) increases with spinal cord injury because of lack of weight bearing. When you're not able to do weight bearing or resistance exercise, your body is less efficient with depositing calcium into your bones. This means you're at an increased risk for osteoporosis and bone fractures.

To help maintain bone density:

  • Be as active as possible.
  • Limit caffeine (it inhibits calcium absorption).
  • Stop smoking.
  • Get adequate calcium daily.

The National Institutes of Health recommendations of optimal calcium intake are as follows:

Age

Recommended calcuim intake/day

in mg (milligrams)


Adolescents and young adults (11 - 24 yrs)


1200 - 1500

Women (25 - 50 yrs)

1000

Post-menopausal women (25 - 65 yrs) on estrogen therapy

1000

Post-menopausal women (25 - 65 yrs) not on estrogen therapy

1500

Men (25 - 65 yrs)

1000

Men and women over 65 yrs.

1500

Good sources of calcium in your diet include:

Calcium fortified orange juice (1 c = 300 mg)

  • Milk - skim, ½%, 1%, 2%, and whole (1 c = 300 mg)
  • Yogurt (1 c = 300 - 450 mg)
  • Cheese (1 oz = 200 - 300 mg)
  • Tofu (½ c = 150 - 250 mg)
  • Ice Cream (½ c = 90 - 135 mg)
  • Frozen Yogurt (½ c = 100 mg)

The calcium content of foods varies. Read labels to determine the actual amount.

When diet alone can't meet your calcium needs, there are many over-the-counter supplements. Calcium carbonate and calcium citrate are the most common types.

► Top

What do I do if I am constipated after spinal cord injury?

The first thing to consider if you're constipated is the amount of fluid, fiber, and exercise you're getting. For some, increasing these three things may alleviate constipation. For those with spinal cord injury, simply increasing fiber and fluid may not be enough, and may actually result in an increase in stool to evacuate.

Probiotic (the “good” bacteria found in your intestinal tract) and prebiotic (the nutrients that promote the growth of probiotic bacteria in your intestinal tract) therapy are possible treatments for constipation. At this time there's little scientific evidence to support this theory.

Fiber/Fluid

For most,it's difficult to get the American Dietetic Association’s recommended amount of fiber per day (20-35g). Fiber adds bulk, softens stool, speeds transit time, and helps with elimination. Dietary fiber is found primarily in high fiber cereals, whole grains, nuts, beans, lentils, fruits, and vegetables.

For constipation, try these meal planning tips:

Drink a hot beverage and/or eat hot cereal in the morning.

  • Add unprocessed bran to foods. Start with adding 1 teaspoon of bran to your morning cereal.
  • Add flaxseed to foods. Start with adding 1 tablespoon ground flaxseed or flaxmeal to cereal or applesauce.
  • Try drinking ¼ to ½ cup of prune juice.
  • Eat a few dried prunes.
  • Slowly increase the amount of fiber per day. Don't increase your fiber intake more than 5 grams per day over a span of 3 to 4 days. Signs that you are increasing the amount of fiber too fast include cramping, bloating, and increased flatulence.
  • As you increase the fiber in your diet, make sure you are getting adequate fluid (2 liters or more per day). Increasing fiber without adequate fluid may make constipation even worse.
  • If increasing fiber and fluid doesn't alleviate your constipation, talk with your healthcare team about the use of fiber supplements, stool softeners, and laxatives.

►Top

© 2012 Mary Free Bed Rehabilitation Hospital., Grand Rapids, MI | 1.855.MFB.REHAB
Powered by Kentico CMS